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23 spring: med surg > Test 1: lecture 7 ekg part 3 > Flashcards

Test 1: lecture 7 ekg part 3 Flashcards

1
Q

4 questions to ask about an EKG

A
  1. Is the rate fast or slow
  2. Is the rhythm regular or irregular?
  3. Is there a P wave for every QRS complex?
    Is there a P wave in front of every QRS complex?
    is there a QRS complex following every P wave?
  4. Are the QRS complexes:
    – Supraventricular
    – Ventricular
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2
Q

NSR for dog

A

70-170 bpm

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3
Q

NSR for cats

A

120-240 bpm

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4
Q

what are some things that cause tachycardia

A

increased sympathetic tone
fever, anemia, heart failure, adrenergic medications, and anxiety

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5
Q

what are some things that cause sinus bradycardia

A

excessive vagal tone
sinus node pathology

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6
Q

what is respiratory sinus arrhythmia

A

increased HR during inhale
decreased HR during exhale

reguarly irregular

common in dogs- caused by increased vagal tone

goes way with exercise, atropine or high sympathetic tone (stress, HF)

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7
Q

what is an example of irregularly irregular

A

Afib

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8
Q
A

sinus arrest
inappropriately long PP interval

long pause can cause fainting

can diagnose with holter monitor

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9
Q

what kind of dogs get sick sinus syndrome

A

long pause cause fainting

schnauzers

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10
Q

symptoms of sinus arrest in cats

A

fainting or seizures

long pause in beats

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11
Q

what is an ectopic beat

A

beat that is started at somewhere other then sinus node

(something is wrong)

QRS without a P wave

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12
Q

the ventricle depolarize without atrial depolarization is a —

A

ectopy

QRS without a P wave

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13
Q
A

ventricular ectopic beat

QRS wide and wierd

conduction is slow from cell to cell cause it has to move through muscle cells instead of normal pathway

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14
Q

what will happen to QRS with a supraventricular ectopic beat

A

impulse starts above the ventricle: sinus node, atrium, AV node

P wave will look abnormal, but QRS normal cause it moves through normal pathway

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15
Q

what is a APC

A

atrial premature beat
supraventricular origin

ectopic beat that is caused by something other then sinus node firing- causes early beat

QRS looks normal

space from normal to APC is called P-P’

P’ may not be seen if too early, hidden by T wave of earlier beat

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16
Q

P-P’

A

space between P wave and Pwave of ectopic beat

if close together with normal QRS normally APC (atrial premature beat)

beat orginates above the ventricle

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17
Q
A

APC
atrial premature beat
supraventricular origin

normal looking QRS

P-P’ very short

18
Q
A

A fib- undulating baseline

Absence of P waves

Supraventricular QRS-T morphology (narrow)

Irregularly irregular rhythm

19
Q

three hallmarks of Atrial Fibrillation

A

Absence of P waves

Supraventricular QRS-T morphology(narrow)

Irregularly irregular rhythm

undulating baseline
20
Q
A

ventricular premature contraction (VPC)

short R-R interval
QRS wide and bizarre
no P wave
T wave looks weird

can be from his-purkinje system or from random ventricular myocardial cell

21
Q

VPCs will cause

A

ventricular premature contraction (VPC)

short R-R interval
wide and bizarre QRS
no P wave

22
Q

R on T phenomenon

A

VPCs that happen right after each other leads to ventricles not contracting properly→ will quiver

ventricular triplet can lead to ventricular fibrillation

no diastolic interval

23
Q
A

normal followed by VPC

probably not causing issues

24
Q
A

R on T phenomenon

PVC
ventricular triplet can lead to ventricular fibrillation

25
Q

3 or more ventricular premature contractions in a row is called

A

ventricular tachycardia

can lead to fainting or Vfib

QRS wide and wierd
QRS slurs into T wave
P wave present,but no relationship to QRS- often can’t see, hidden by QRS complex

26
Q
A

V tach

3 or more VPC in a row
QRS wide and wierd
QRS slurs into T wave
P present but hidden by QRS

can lead to fainting, if R on T can lead to Vfib

27
Q

escape vs premature ectopic ventricular beat

A

premature: happens before normal R-R interval

escape: long cause then wierd QRS, ventriculars sense no atrial beat and secondary pacemakers will depolarize spontaneously

28
Q

HR controlled by AV node will be

A

40-60 bpm

29
Q

HR controlled by purkinje cells would be

A

20-40 bpm

30
Q
A

escape beat

beat caused by ventricle when there is no signal from atrium to beat

causes wierd wide QRS

31
Q
A

ventricular premature beat

beat with wide and wierd QRS before normal R-R interval

32
Q
A

ventricular escape beat

happens later, beat started by ventricle when no beat from atrium

wierd and wide QRS

33
Q
A

PVC every 3rd beat

premature ventricular contraction

wierd and wide QRS

34
Q
A

PVCs moving into Vfib

lethal rhythm

35
Q
A

1st degree AV block

slowed conduction: long PR interval

36
Q
A

2nd degree AV block

intermittent failure of conduction: sometimes no QRS complex following P wave

wenckebach

37
Q
A

3rd degree AV block

AV conduction is absent

P-waves are never followed by a QRS complex
ventricles depolarize from subsidiary pacemakers

38
Q

1st degree AV block

A

Slowed conduction: PR interval prolonged

39
Q

2nd degree AV block

A

Intermittent failure of conduction: sometimes no QRS complex following P-wave

type 1 wenckebach

40
Q

3rd degree AV block

A

complete

AV conduction is absent
* P-waves are never followed by a QRS complex
* ventricles depolarize from subsidiary pacemakers

P waves just doing its own thing, no QRS after it
QRS that do show up are caused by ventricules, will be wierd and wide, but are needed to beat ventricles= do not stop with meds

41
Q

what can causes arrhythmias

A

scar tissue(infracts/ischemia)

Disturbance of ionic homeostasis in myocytes (high K)

drugs, stress (adrenaline)

genetic defects in ion channels
– Genetic defects in gap junctions between cells allowing normal electrical conduction(boxers)

42
Q

when to treat a patient with abnormal EKG

A

Hemodynamic compromise due to arrhythmia
→ reduced cardiac output
→clinical signs: fainting, exercise intoleracne, hypotension, hypothermic

Patients at significant risk for sudden death
→ with underlying heat disease
→ dilated cardiomyopathy (doberman), subarotic stenosis, hypertropic cardiomyopathy(Cats)

23 spring: med surg (60 decks)

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